Sprains, Strains and Muscular Gains - Get Relief with Platelet Rich Plasma Therapy

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For many of us, tendonitis is a part of life. With our innovative Platelet Rich Plasma (PRP) therapy, it doesn’t have to be. Dr. Sharma offers expertise in a new therapeutic procedure that can provide natural and accelerated healing of tendon injuries & osteoarthritis.

Learn how PRP can:
• accelerate healing by using blood’s own curative
properties
• naturally remedy injured tissue or osteoarthritis
• treat sprains and strains with a non-surgical healing procedure

Published in: Health & Medicine

Sprains, Strains and Muscular Gains - Get Relief with Platelet Rich Plasma Therapy

  1. 1. Advances in the Treatment of Tendon Injuries Rishi Sharma, MD, Sports Medicine www.SpringfieldClinic.com
  2. 2. Common Tendon Problems <ul><li>Shoulder </li></ul><ul><li>Elbow </li></ul><ul><li>Wrist </li></ul><ul><li>Hip </li></ul><ul><li>Knee </li></ul><ul><li>Ankle & Foot </li></ul>
  3. 3. Tendon: What is it? <ul><li>Fibrous connective tissue that connects muscle to bone </li></ul>
  4. 4. Tendon: What is the function? <ul><li>Acts as a spring to collect and release force </li></ul>
  5. 5. Common Names for Tendinopathy <ul><li>Tendonitis </li></ul><ul><li>Peritendonitis </li></ul><ul><li>Tendinopathy </li></ul><ul><li>Tenosynovitis </li></ul><ul><li>Apophysitis </li></ul><ul><li>Insertitis </li></ul><ul><li>Bursitis </li></ul><ul><li>Enthesopathy </li></ul>
  6. 6. How is it injured? <ul><li>Tendinopathy </li></ul><ul><ul><li>Degeneration of the tendon </li></ul></ul><ul><li>Tendinitis </li></ul><ul><ul><li>Overuse </li></ul></ul><ul><li>Tendon Tears </li></ul><ul><ul><li>Injury </li></ul></ul>
  7. 7. Microscopic Tendon RUPTURED TENDON ACHILLES TENDINOPATHY NORMAL TENDON ROTATOR CUFF TENDINOPATHY
  8. 8. Can the tendon heal itself? <ul><li>Depends </li></ul><ul><ul><li>Full-thickness </li></ul></ul><ul><ul><ul><li>usually no </li></ul></ul></ul><ul><ul><li>Tendinopathy </li></ul></ul><ul><ul><ul><li>usually yes </li></ul></ul></ul>
  9. 9. How does tendinopathy heal? <ul><li>Inflammation </li></ul><ul><li>Repair </li></ul><ul><li>Remodeling </li></ul>
  10. 10. How does tendinopathy heal? <ul><li>Inflammation </li></ul><ul><li>Repair </li></ul><ul><li>Remodeling </li></ul>
  11. 11. How does tendinopathy heal? <ul><li>Inflammation </li></ul><ul><li>Repair </li></ul><ul><li>Remodeling </li></ul>
  12. 13. What is the problem with the tendon? <ul><li>Tendinopathy </li></ul><ul><li>Full-thickness tear </li></ul>
  13. 14. Etiology of Tendon Disorders <ul><li>Repetitive and prolonged exertion </li></ul><ul><li>Sudden increase in training </li></ul><ul><li>Pre-existing tendinosis </li></ul><ul><li>Acute trauma </li></ul>
  14. 15. Shoulder <ul><li>Rotator Cuff Tendon </li></ul><ul><ul><li>Continuum from: </li></ul></ul><ul><ul><ul><li>Tendinopathy to Full-thickness Rotator Cuff Tear </li></ul></ul></ul><ul><li>Biceps Tendon </li></ul>
  15. 16. Rotator Cuff Pain <ul><li>Insidious onset of pain </li></ul><ul><li>Middle aged </li></ul><ul><li>Increasing pain with activity </li></ul><ul><li>Can have decreased range of motion or weakness </li></ul>
  16. 17. Elbow
  17. 18. Elbow <ul><li>Tennis Elbow </li></ul><ul><ul><li>Lateral Epicondylitis </li></ul></ul><ul><li>Golfer’s Elbow </li></ul><ul><ul><li>Medial Epicondylitis </li></ul></ul>
  18. 19. Tennis Elbow
  19. 20. Tennis Elbow <ul><li>Common extensor tendon </li></ul>
  20. 21. Golfer’s Elbow
  21. 22. Wrist <ul><li>DeQuervain’s tenosynovitis </li></ul>
  22. 23. Hip <ul><li>Trochanteric Bursitis </li></ul>
  23. 24. Hip <ul><li>Hamstring </li></ul><ul><li>Hip Flexors </li></ul>
  24. 25. Knee <ul><li>Quadriceps tendon </li></ul><ul><li>Patellar tendon </li></ul>
  25. 26. Foot & Ankle <ul><li>Achilles tendon </li></ul><ul><li>Peroneal tendon </li></ul><ul><li>Tibialis posterior tendon </li></ul><ul><li>Tibialis anterior tendon </li></ul>
  26. 27. Medications
  27. 28. Bracing
  28. 29. Physical Rehabilitation
  29. 30. Corticosteroid Injections
  30. 31. Topaz - Radiocoblation
  31. 32. Surgical Treatment <ul><li>Achilles Tendinopathy </li></ul>
  32. 33. Emerging Treatments <ul><li>Topical Glycerol Trinitrate </li></ul><ul><li>Proliferation Therapy </li></ul><ul><li>Botulinium Toxin A </li></ul><ul><li>Acupuncture </li></ul><ul><li>Low Level Laser Therapy </li></ul><ul><li>Platelet Rich Plasma </li></ul>
  33. 34. Platelet-Rich Plasma <ul><li>Sample of blood with a platelet concentration of at least 1,000,000 platelets/micromL in 5 mL of plasma </li></ul>
  34. 35. Platelet-Rich Plasma
  35. 36. Types of Platelet Rich Plasma <ul><li>Tier One </li></ul><ul><ul><li>Arteriocyte Magellan </li></ul></ul><ul><ul><li>Harvest SmartPRep </li></ul></ul><ul><ul><li>Biomet GPS II </li></ul></ul><ul><li>4-5 x’s baseline platelet concentration </li></ul><ul><li>Tier Two </li></ul><ul><ul><li>Arthrex </li></ul></ul><ul><ul><li>Cascade </li></ul></ul><ul><li>2-3 x’s baseline concentration </li></ul>
  36. 37. Tier One: PRP <ul><li>Arteriocyte Magellan </li></ul>
  37. 38. Tier Two <ul><li>Arthrex </li></ul>
  38. 39. Platelet-Rich Plasma <ul><li>What do platelets contain? </li></ul><ul><ul><li>alpha granules </li></ul></ul><ul><ul><ul><li>PDGF </li></ul></ul></ul><ul><ul><ul><li>VEGF </li></ul></ul></ul><ul><ul><ul><li>EGF </li></ul></ul></ul><ul><ul><ul><li>IGF-1 </li></ul></ul></ul>
  39. 40. How do we know where to inject?
  40. 41. Ultrasound <ul><li>Patellar tendinopathy </li></ul>
  41. 42. Ultrasound <ul><li>Achilles tendinopathy </li></ul>
  42. 43. Rotator Cuff Disorders <ul><li>Diagnostic Ultrasound </li></ul><ul><ul><li>Partial and Full thickness tears </li></ul></ul><ul><ul><li>Tendinopathy </li></ul></ul>
  43. 44. Evidence of PRP <ul><li>Double blind randomized study showed PRP better than corticosteroid at 26 and 52 weeks </li></ul><ul><ul><li>AJSM Feb 2010 </li></ul></ul>
  44. 45. PRP Evidence <ul><li>Mishra, et. al; in a pilot study; has had success in the management of chronic elbow tendinosis with PRP </li></ul><ul><li>Scarpone, et. al; showed statistical significance in pain scores for the management of rotator cuff tendonipathy with PRP </li></ul><ul><li>Barret, et. al. had found significant symptom relief in patients with plantar facciitis who underwent PRP therapy. </li></ul>
  45. 46. May not work for everyone

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